| Ms Jennifer Lea Lea Claycomb, MD | |
|
500 North Mundo, Dulce, NM 87528-0187 | |
| (505) 759-3291 | |
| (505) 759-3532 |
| Full Name | Ms Jennifer Lea Lea Claycomb |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 21 Years |
| Location | 500 North Mundo, Dulce, New Mexico |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144323353 | NPI | - | NPPES |
| 000K3526 | Medicaid | NM | |
| 01929259 | Medicaid | NM | |
| HSZ196 | Other | NM | MEDICARE PART B |
| 8HN171 | Other | NM | PROVIDER MEDICARE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2005019602 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cherokee Nation W W Hastings Indian Hospital | Tahlequah, OK | Hospital |
| Northeastern Health System | Tahlequah, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cherokee Nation | 5799698742 | 369 |
| Entity Name | Cherokee Nation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780692723 PECOS PAC ID: 5799698742 Enrollment ID: O20031106000628 |
| Entity Name | Dulce Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750388963 PECOS PAC ID: 7012991839 Enrollment ID: O20040617000747 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jennifer Lea Lea Claycomb, MD Po Box 187, Dulce, NM 87528-0187 Ph: (505) 759-3291 | Ms Jennifer Lea Lea Claycomb, MD 500 North Mundo, Dulce, NM 87528-0187 Ph: (505) 759-3291 |
Sirpa T. Autio, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 500 N Mundo, Dulce, NM 87528 Phone: 575-759-3291 Fax: 575-759-3532 | |
Dr. Joan E Kandel, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 90 Medicine Way, Dulce, NM 87528 Phone: 505-360-5995 | |
Steven John Petrakis, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 500 North Mundo, Dulce, NM 87528 Phone: 575-759-3291 Fax: 575-759-7294 | |
Dr. Bichson Pham, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 500 North Mundo, Dulce, NM 87528 Phone: 575-759-3291 | |
Steven Paul Gross, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 12000 Stone Lake Road, Dulce, NM 87528 Phone: 575-759-7232 Fax: 575-759-7294 | |
Dr. Raquel Irene Cisneros, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 500 N. Mundo Dr., Dulce, NM 87528 Phone: 575-759-3291 Fax: 575-759-7294 |